| 1. |
- Almén, Anja, 1964, et al.
(författare)
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OPTIMISATION OF OCCUPATIONAL RADIATION PROTECTION IN IMAGE-GUIDED INTERVENTIONS: EXPLORING VIDEO RECORDINGS AS A TOOL IN THE PROCESS
- 2016
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Ingår i: Radiation protection dosimetry. - : Oxford University Press (OUP). - 1742-3406 .- 0144-8420. ; 169:1-4, s. 425-429
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Tidskriftsartikel (refereegranskat)abstract
- The overall purpose of this work was to explore how video recordings can contribute to the process of optimising occupational radiation protection in image-guided interventions. Video-recorded material from two image-guided interventions was produced and used to investigate to what extent it is conceivable to observe and assess dose-affecting actions in video recordings. Using the recorded material, it was to some extent possible to connect the choice of imaging techniques to the medical events during the procedure and, to a less extent, to connect these technical and medical issues to the occupational exposure. It was possible to identify a relationship between occupational exposure level to staff and positioning and use of shielding. However, detailed values of the dose rates were not possible to observe on the recordings, and the change in occupational exposure level from adjustments of exposure settings was not possible to identify. In conclusion, the use of video recordings is a promising tool to identify dose-affecting instances, allowing for a deeper knowledge of the interdependency between the management of the medical procedure, the applied imaging technology and the occupational exposure level. However, for a full information about the dose-affecting actions, the equipment used and the recording settings have to be thoroughly planned.
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| 2. |
- Båth, Magnus, 1974, et al.
(författare)
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Effective dose to patients from chest examinations with tomosynthesis
- 2010
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Ingår i: Radiation protection dosimetry. - : Oxford University Press (OUP). - 1742-3406 .- 0144-8420. ; 139:1-3, s. 153-158
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Tidskriftsartikel (refereegranskat)abstract
- Chest tomosynthesis, which refers to the principle of collecting low-dose projections of the chest at different angles and using these projections to reconstruct section images of the chest, is an imaging technique recently introduced to health care. The main purpose of the present work was to determine the average effective dose to patients from clinical use of chest tomosynthesis. Exposure data for two chest radiography laboratories with tomosynthesis option (Definium 8000 with VolumeRAD option, GE Healthcare, Chalfont St. Giles, UK) were registered for 20 patients with a weight between 60 and 80 kg (average weight of 70.2 kg). The recorded data were used in the Monte Carlo program PCXMC 2.0 (STUK-Radiation and Nuclear Safety Authority, Helsinki, Finland) to determine the average effective dose for each projection. The effective dose for the chest tomosynthesis examination, including a scout view and the tomosynthesis acquisition, was finally obtained by adding the effective doses from all projections. Using the weighting factors given in ICRP 103, the average effective dose for the examination was found to be 0.13 mSv, whereas the average effective dose for the conventional two-view chest radiography examination was 0.05 mSv. A conversion factor of 0.26 mSv Gy(-1) cm(-2) was found suitable for determining the effective dose from a VolumeRAD chest tomosynthesis examination from the total registered kerma-area product. In conclusion, the effective dose to a standard-sized patient (170 cm/70 kg) from a VolumeRAD chest tomosynthesis examination is ~2 % of an average chest CT and only two to three times the effective dose from the conventional two-view chest radiography examination.
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| 4. |
- von Wrangel, Alexa, 1967, et al.
(författare)
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Fluoroscopically guided percutaneous vertebroplasty: assessment of radiation doses and implementation of procedural routines to reduce operator exposure.
- 2009
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Ingår i: Acta radiologica (Stockholm, Sweden : 1987). - : SAGE Publications. - 1600-0455 .- 0284-1851. ; 50:5, s. 490-6
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Percutaneous vertebroplasty (PVP) is a fluoroscopically guided procedure for the treatment of painful vertebral compression fractures and metastases. Routine legal personal dosimetry repeatedly showed dosimeter doses exceeding 1 mSv/month for the only radiologist performing PVP at our hospital. Based on the nature of the procedure, this raised concern about potentially high doses to the eyes and fingers. PURPOSE: To assess radiation doses to the operator, and to evaluate possibilities for dose reduction. MATERIAL AND METHODS: Measurements of scattered radiation in simulated thoracic and lumbar PVP procedures were performed using two anatomical phantoms--thorax and lower trunk--and a radiation survey meter. The standard position of the operator was determined as being 50 cm from the irradiated area of the phantom. The protection ability of lead-free gloves was evaluated during the simulations. Operator doses to fingers and eyes during 10 clinical PVP procedures performed by a single operator were measured, and the annual dose was calculated. Routine personal dosimetry was performed using thermoluminescent dosimeter (TLD) badges beneath the lead apron, and doses to fingers and eyes were measured with small TLD tablets. RESULTS: During simulations, the measured operator dose rate arising from lateral fluoroscopy at the thorax and lumbar level was reduced by a factor of 4-5 when the X-ray tube was moved from the operator's side of the patient to the opposite side. Wearing protective gloves reduced radiation dose to the hands by 30-40%. The mean doses arising from the 10 clinical PVP procedures to the right and left hands, using protection gloves, were 2.0 mSv and 4.8 mSv, respectively. The mean dose to the eyes was 0.23 mSv. The mean effective dose to the patients was 12 mSv. CONCLUSION: Placing the X-ray tube on the side of the patient opposite to the operator and the use of radiation protection gloves significantly reduces radiation exposure to the operator. In phantom simulations, the dose was reduced by a factor of 4-5. Knowledge of fluoroscopy equipment, radiation physics, and protection is essential in order to reduce exposure.
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| 5. |
- von Wrangel, Alexa, 1967, et al.
(författare)
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Video as a tool for optimization of radiological protection in image-guided interventions – possibilities and limitations
- 2015
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Ingår i: Optimisation in X-ray and Molecular Imaging 2015 - the Fourth Malmö Conference on Medical Imaging, Gothenburg, Sweden, 28-30 May 2015.
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Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract
- In healthcare, the highest patient and staff doses are received in image-guided intervention. This area includes a large variation of procedures with various prerequisites for performing radiological protection. Traditionally, radiation protection has mainly consisted of monitoring staff dose and providing personal radiation shielding in addition to education and training. New strategies have to be developed to achieve an optimized radiation protection in these changing environments. It could be anticipated that video could be a useful tool for optimization. The aim of this work was to develop video as a tool for optimization of radiological protection in image-guided interventions. Video recordings of the staff during image-guided abdominal interventions have been performed. Three cameras were used. Camera one was placed to get an overview of the room. The second camera was placed on the monitor facing the staff and camera three was recording the live monitor from the x-ray system. The video recordings were visually analyzed. Technical parameters were additionally collected from the x-ray system. Dose rate data was also collected during the procedures. So far, three procedures have been analysed in order to develop the optimization tool. The most important camera angle was the one over viewing the room. It was with the chosen angles, however, difficult to see what the staff members were looking at during the procedures. In developing the tool the following has been identified as important issues to consider; the number and position of cameras, the sound quality, editing of video material and safety issues. Furthermore, it is important to consider the competence of the evaluating team, which need to be multidisciplinary. Above all, ethical aspects of recording patients and staff have to be addressed. The present study combines video recordings of the interventional staff with information of the variation of dose rates during the procedure. This is a novel approach for education and training strategies.
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